LCQ19: Public dental services
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Question:
There are views that as the population of Hong Kong is ageing, dental services are facing great challenges. There were nearly 310 000 poor elderly persons in 2015, representing a poverty rate of 30 per cent. Quite a number of elderly persons are suffering from various dental problems and rely on public dental services heavily. However, such services are grossly inadequate, rendering elderly persons with financial difficulties unable to receive diagnoses and treatments. Regarding public dental services, will the Government inform this Council:
(1) whether it knows the number of dentists who obtained practising qualifications in each of the past five years;
(2) whether it knows the current number of registered dentists in Hong Kong and, among them, the respective numbers of dentists practising in public organisations and private dental clinics/organisations;
(3) of the specific measures in place to increase dentist manpower;
(4) of the specific measures in place to encourage non-locally trained dentists and graduates in dentistry to come to Hong Kong and practise in public organisations;
(5) whether it has projected the manpower demand and supply situation of dentists in each of the coming 10 years; if so, of the details; if not, the reasons for that;
(6) whether it has plans to increase the number of dental clinics under the Department of Health, so as to expand the free emergency dental treatment (commonly known as "general public dental sessions" (GP dental sessions)) provided for the public; if so, of the details; if not, the reasons for that;
(7) whether it will consider increasing the consultation quota of GP dental sessions through means such as allocating resources and streamlining procedure; and
(8) whether it will introduce a population-wide dental care scheme; if so, of the details and timetable; if not, the reasons for that?
Reply:
President,
(1) The annual number of newly-registered dentists in the past five years are set out in the table below:
| Year | 2014 | 2015 | 2016 | 2017 | 2018 |
| Number | 53 | 58 | 70 | 65 | 71 |
(2) As at end of May 2019, there were 2 342 dentists on the list of registered dentists in Hong Kong under the Dentists Registration Ordinance (Cap. 156).
According to the 2015 Health Manpower Survey conducted by the Department of Health (DH), the distribution of those economically active dentists who were practising in different sectors is set out in the following table:
| Sector of Work* | Government | Private | Others † |
| Percentage of Dentists | 19.5% | 74.0% | 6.5% |
* Figures refer to the sector in which the dentists worked for the main job.
† Figures included dentists working in the Hospital Authority, subvented sector, academic sector and Prince Philip Dental Hospital.
(3) To meet the anticipated demand for dental manpower, the Government has increased the annual intake of University Grants Committee (UGC)-funded first-year-first-degree (FYFD) training places in dentistry from 53 to 73 by 20 (about 40%) in the 2016/17-2018/19 triennium. In the 2019/20 to 2021/22 triennium, the number of UGC-funded FYFD places in dentistry will be further increased to 80 per annum. The Government will also provide for 20 UGC-funded taught postgraduate places in dentistry in the 2019/20 to 2021/22 triennium.
(4) Under Dentists Registration Ordinance (Cap. 156), there is an arrangement of deemed registration for dentists recruited from overseas for the purpose of teaching and performing hospital work in the Faculty of Dentistry of the University of Hong Kong.
There are suggestions from the dental profession to introduce a limited registration mechanism similar to that for doctors to facilitate qualified non-locally trained professional to practise dentistry in Hong Kong for teaching, research and hospital work under prescribed conditions, and to abolish the arrangement of deemed registration upon the introduction of limited registration to strengthen professional regulation.
The Government has invited the Dental Council of Hong Kong to make proposal on how to implement the recommendations of the Strategic Review on Healthcare Manpower Planning and Professional Development (Strategic Review) (including the establishment of a limited registration mechanism for dentists). The Government will continue to actively liaise with the Council on the recommendations of the Strategic Review.
(5) The Government published the Report of Strategic Review on Healthcare Manpower Planning and Professional Development (Report) in mid-2017. The projections on healthcare manpower have taken into account demographic changes and other relevant factors, including the known and planned services and developments, the requirements of public and private healthcare, social welfare and education sectors, as well as the demand for primary, secondary and tertiary care services in Hong Kong.
According to the manpower projections in the Report, the manpower of dentists will be in shortage in the medium to long term. The manpower gaps for dentists in 2020, 2025 and 2030 are set out in the table below –
| Manpower Gap | |||
| 2020 | 2025 | 2030 | |
| Best guestimate | 96 | 121 | 127 |
| (4.2%) | (5.1%) | (5.1%) | |
Taking into account the findings of the Report, the Government will increase the number of UGC-funded FYFD training places in dentistry from 73 to 80 per annum in the 2019/20 to 2021/22 triennium. The Government has commenced a new round of manpower projection exercise. The results are expected to be available in 2020. Subject to the result of the new manpower projection, the Government will further consider increasing the number of FYFD training places in dentistry in the next triennium.
(6) to (8) The Government's policy on dental services aims to raise public awareness of oral health and encourage the public to develop proper oral health habits through promotion and education. To enhance oral health of the community, the Oral Health Education Unit of the DH has implemented oral health promotion programmes targeting different age groups and disseminated oral health information through various channels over the years.
Providing comprehensive dental services for the public requires substantial amount of financial resources. Therefore, besides publicity, education (including the School Dental Care Service) and promotion on oral health, the Government shall allocate resources to the provision of emergency dental services to the public and prioritise resources for persons with special dental care needs, in particular elderly with financial difficulties.
The dental clinics under the DH are mainly responsible for providing dental benefits for civil servants/pensioners and their eligible dependents as required of the Government as terms of employment for civil servants, and therefore civil servants/pensioners and their eligible dependents are the major service targets of these clinics. Nonetheless, the Government provides general public sessions to offer free emergency dental treatments to the public through designated sessions in 11 government dental clinics of the DH. In addition, the Oral Maxillofacial Surgery and Dental Units of the DH in 7 public hospitals provide specialist dental treatment to the special needs groups by referral from registered dental or medical practitioners. Currently, the government dental clinics are at full service capacity reaching almost 100 per cent occupancy of all appointment time slots. It is not possible for DH to extend or allocate more slots for general public sessions on top of the existing schedule.
Regarding the question raised about the need of elderly dental services, the Government has launched the Outreach Dental Care Programme for the Elderly through subventing non-governmental organisations to provide free outreach dental services for elders in residential care homes or day care centres, and those residing in similar facilities (e.g. Nursing Homes for the elderly registered under the DH).
Moreover, in September 2012, the Community Care Fund Elderly Dental Assistance Programme (the Programme) was launched for provision of free removable dentures and related dental services to eligible low-income elders. The Programme was expanded in phases in the past few years to cover elders aged 65 or above receiving Old Age Living Allowance in February 2019.
Besides, under the Comprehensive Social Security Assistance Scheme, recipients who are old, disabled or medically certified to be in ill health are eligible for a dental grant to cover the dental treatment items (including dentures, crowns, bridges, scaling, fillings, root canal treatment and tooth extraction).
Currently, the Elderly Health Care Voucher Scheme also subsidises eligible elders aged 65 or above with an annual voucher amount of $2,000 to use private primary healthcare services, including dental services.
Ends/Wednesday, June 26, 2019
Issued at HKT 12:40
Issued at HKT 12:40
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